US2989960A - Adapter fitting for anesthetic administering circuits - Google Patents

Description

W. W. HAY

June 27, 1961 ADAPTER FITTING FOR ANESTHETIC ADMINISTERING CIRCUITS Filed Dec. 23, 1958 2 Sheets-Sheet 1 WAYNE W. HAY

W .7 ATTORNEY 8. AGENT W. W. HAY

June 27, 1961 ADAPTER FITTING FOR ANESTHETIC ADMINISTERING CIRCUITS Filed Dec. 23, 1958 Sheets-Sheet 2 INVENTOR. WAYNE W. HAY

bzgm f7 ATTORNEY & AGE NT United, States Patent 015 ice Patented June 27, 1961 2,989,960 ADAPTER FITTING FOR ANESTHETIC ADMINIS'DERING CIRCUITS Wayne W. Hay, Madison, Wis., assignor to Air Reduction Company, Incorporated, New York, N.Y., a corporation of New York Filed Dec. 23, 1958, Ser. No. 782,584

Claims. (Cl. 128188) This invention relates to adapter fittings used to connect conduit elements in anesthetic circuits for administering anesthetic gases and vapors by inhalation. More particularly, the invention concerns improvements in socalled Y-adapters employed in closed anesthetic circuits to provide a connection between the inhalation and exhalation conduits of the circuit and an inhaler device through which a patients respiratory gases are breathed.

In a closed type anesthetic circuit, the patients exhalation gases are circulated through an absorbent to remove carbon dioxide and'thence are returned to the patient for reinhalation. The absorber portion of the circuit is customarily provided with separate, flexible conduits leading to and from the absorber which are attached to a suitable inhaler device such as a catheter or a face mask. Check valves are located in the respective exhalation and inhalation sides of the circuit to cause the gases to move progressively through the circuit and thence return to the patient. The Y-adapter is provided to facilitate the connection of the anesthetic circuit elements to the inhaler and also desirably serves to reduce or minimize the dead space or volume common to the inhalation and exhalation portions of the circuit which constitutes a volume of gases in the circuit that is not circulated through the absorber and represents an inefliciency in the respiratory exchange obtain able in the system. It is conventional, in such circuits, to administer make-up oxygen in amounts suflicient to replenish the oxygen consumed by the patient and to introduce, in any suitable fashion, anesthetic vapors or gases which are inhaled by the patient to maintain a desired depth of anesthesia.

Due to the complexities of modern surgery and the numerous specialized surgical procedures now in common practice, it is desirable that the closed circuit be capable of use under specialized surgical procedures and, at the same time, permit a maximum degree of flexibility in the positioning and arrangement of the physical elements of the administering equipment. For this reason, it has been felt that an adapter having the respective connections for the flexible conduits relatively adjustable to one another would be advantageous. It is also deemed desirable to provide such an adapter through which the opening or connecting element from the adapter to the patient inhaler might be directly visible to the anesthetist while in use so that the condition and physiological behavior of the patient while under anesthesia could be more readily observed. Thus, for example, vomiting or the discharge of mucus have frequently interfered with the proper breathing of the patient by entering the inhaler or adapter inadvertently and Without the knowledge of the anesthetist so as to block the free exchange of respiration gases. Means enabling the anesthetist to directly oberve the interior of the Y-adapter passages and connection to the inhaler will greatly assist in overcoming such occurrences.

It is also desirable in a number of situations, and is preferred by many anesthetists, to arrange the respective inhalation and exhalation check valves of the anesthetic circuit directly in the Y-adapter. Adequate provision is necessary to permit the anesthetist to observe that the check valves are functioning properly, particularly when the valves are located in such close proximity 2 to the region accessible to the discharged vomitus of mucus. Allowing visible inspection of the'interior of the Y-adapter may additionally afford a means for the desired inspection of the check valves disposed within the Y-adapter.

In some instances, portions of the Y-adapter have been made of a transparent plastic material which makes it possible for the anethetist to inspect the interior of the adapter for the purposes indicated above. However, such transparent materials are nonconductive and without further provision amount to the insertion of an insulating member between the inhaler, whichis conventionally either metallic or of conductive rubber construction, and the tubular breathing conduits which similarly are of electrically conductive construction and conventionally grounded by a suitable electrically conductive means to avoid the accumulation of static electric charges in the anesthetic circuit. Such static charges are well recognized as a potential hazard which, upon rapid discharge, may cause explosive detonation of the anesthetic mixtures within the circuit. Consequently, it is standard practice to utilize, in anesthetic apparatus, elements or other means which furnish a completely electrically conductive path so that such charges may not be accumulated. It has, therefore, been a significant problem to furnish a Y-adapter having a transparent construction as indicated above which adequately overcomes the problem of electrical conductivity and which, at the same time, affords a high degree of flexibility for the arrangement and orientation of the connections for the respective conduit elements of the circuit and which, at the same time, permits a convenient location of the inhalation and exhalation check valves therein. In addition, there is the further problem in the provision of such a type of Y-adapter of constructing such an adapter in a manner permitting it to be readily dismantled for thorough cleaning and sterilization for continued use.

Accordingly, it is an object of the present invention to provide an improved adapter for anesthetic administen'ng apparatus forming an adjustable connection between an inhaler and the inhalation and exhalation conduits of an anesthetic circuit.

A further object of the present invention is to provide a Y-adapter for anesthetic apparatus having a barrel portion of substantially transparent construction provided with means for connection thereof with an inhaler and relatively adjustable end pieces carried thereon adapted to receive anesthetic circuit conduits.

A further object of the invention is to provide a Y- adapter such as that indicated above having a post member extending through said barrel portion interconnecting the relatively adjustable end pieces and wherein inhalation and exhalation check valve means are carried thereon.

It is a still further object of the present invention to provide a Y-adapter for anesthetic administering apparatus having a central barrel portion arranged for connection with an inhaler, relatively adjustable end pieces supported thereon and resilient means interposed between said inhaler and the adjustable end pieces for maintaining an electrically conductive path between the inhaler and the adjustable end pieces.

Other objects and advantages of the present invention will become more apparent by reference to the following description of a preferred embodiment thereof and the accompanying drawings in which:

FIG. 1 is a side elevation view partially in section showing a Y-adapter in accordance with a preferred embodiment of the present invention, seated in a face mask and illustrating the adjustable end pieces of the adapter in relatively rotated positions;

FIG. 2 is a plan sectional view taken substantially along the line 2-2 in FIG. 1 looking in the direction of the arrows, with the end pieces shown in the same plane;

FIG. 3 is a partial sectional view taken substantially along the line 3-3 in FIG. 1, with the securing means and valve elements removed, showing the means for connecting theY-adapter to the face mask and illustrating in greater detail resilient, electrically conductive means interposed between the inhaler and the end pieces;

' FIG 4 shows the metallic bushing element providing the resilient connector means of FIG. 3 in an exploded view; V v

FIG; 5 is an end view of the inhalation check valve with the disc valve element thereof partially broken away;

FIG. 6 is a plan sectional view taken substantially along the line 66 in FIG. 3 looking in the direction of th arrows;

FIG. 7 is an enlarged partial sectional view illustrating in greater detail the securing means for holding the adjustable portions of the Y-adapter in assembled relation; and

FIG.'8 is a sectional view showing a detail of construction of the securing means taken substantially along the line 88 in FIG. 7 looking in the direction of the arrows.

Referring to FIG. .1, Y- adapter is shown generally at 10 which includes a central barrel portion, or hub, 12 having at the opposite ends thereof relatively rotatable end pieces, or nipples, 1 4 and 16 to which are connected, respectively, the'ends of flexible corrugated conduits 18 and 20. A tubular extension 22 of the central hub 12 forms a nipple connector having an opening 23 which communicates with a face mask shown at 24. The face mask is provided with a cylindrical opening 25 in which the connector 22 of the adapter is received. A metal hook-ring 26 is secured on the upper part of the mask body as is well known to permit the mask to be held securely in place against the face of the patient by means of an elastic head band. A relief valve shown at 28 is arranged in the hub portion of the Y-adapter in communication with the chamber 12 therein, seen in FIG. 2, and operates to relieve the pressure within the anesthetic breathing circuit in the event the pressure level therein rises above a predetermined value. It will be understood that the corrugated hose conduits 18 and 20, seen in FIG. 1, may be connected to other devices, including, for example, a carbon dioxide absorber and other accessories, through which the respiratory gases are conducted, to form a conventional closed anesthetic circuit. The circuit is not shown and need not be described in'detail Since such expedients will be well known and understood to those skilled in the art.

' The barrel portion 12 of the adapter may be made of a transparent plastic material such, for example, as a clear cellulose, acetate, butyrate polymer so that the inner central chamber 12' is visible through the walls thereof. 'The ends of the central barrel portion of the adapter are recessed at 29 to provide openings for receiving the matching cylindrical faces of the end pieces 14 and 16 as may best be seen in FIG. 2. The end pieces are held in assembled relation with the barrel portion of the adapter by a central elongated stem 30 which is rigidly seated in a cylindrical receptacle 32 in the end piece 16 and secured at its opposite threaded end 34 by a retaining nut designated generally by the numeral 36, bearing against the opposite end piece 14. The arrangement of the retaining nut may best be seen in FIG. 7. The end piece 14 is provided with a cup-shaped cavity 38, the inner wall of which is provided with an opening 40 through which the threaded end 34 of the retaining stem protrudes. The retaining nut 36 has an internally threaded barrel portion 42 that may be threaded along the length of the threaded end of the stem 34. A selfretaining washer member 44 is carried on the barrel portion 42 of the retaining nut and is retained thereon by the inwardly crimped end '46 so that the washer is rotatable relative to the retaining nut. The opening 48 in the washer is not circular but has parallel sidewalls shown at 48 in FIG. 8 which correspond to the opposite milled faces 34' formed at the threaded end 34 of the retaining stern. Such construction prevents the rotation of the washer 44 relative to the retaining stem but permits relative rotational movement of the retaining nut 36 required for longitudinal movement thereof in orderto secure the assembled parts of the adapter. In this arrangement, the washer 44, upon tightening of the retaining nut is urged thereby against the bottom face 38' at the bottom of the cup-shaped depremsion 38 in the end piece 14. By such inward threading of the retaining nut, it can be seen that the end pieces 14 and 16 are clamped and thus secured against the opposite ends of the central barrel portion of the adapter. The retaining nut may be threaded sufficiently that the pressure produced against the end pieces will retain them against relative rotational adjustment under normal forces exerted on the adapter during use. In order to adjust the angular position of the end pieces, the retaining nut preferably is slightly loosened. Alternatively, the retaining nut may be tightened to a slightly less degree to permit manual adjustment of the end pieces without loosening the nut. It can be seen that the rotation of the retaining post produced by relative angular adjustment between the end pieces 14 and 16 of the adapter will not tend to afiect the setting of the retaining screw 36 inasmuch as the retaining screw moves as a unit with the retaining stern and the frictional eifects exerted throughthe end piece 14 are absorbed by the intermediate washer 44 that is mechanically linked with the central stem. Thus, the washer and retaining nut do not have relative rotation during manipulation of the end pieces. Relative angulations of the end pieces consequently will not result in unthreading the screw and possibly allowing eventual complete separation of the adapter parts such as might otherwise be possible.

The chamber 12 within the central portion of the adapter is separated from chambers 50 and 52 in the end pieces, respectively, by inhalation and exhalation check valve units shown at 54 and 56. The check valve units are of identical construction and are arranged with respect to one another in the usual manner so that inhalation valve 54 opens into the chamber 12' allowing the gases to be drawn into the chamber when the patient inhales, and so that exhalation valve 56 opens from the chamber allowing discharge of gases therefrom when the patient exhales. Each of the valve units includes a central collar 58 which is slidably received on the retaining stem 30. An annular rim 60 extends concentrically about the central collar and is connected therewith by a plurality of radial spokes 62 that are best seen in FIG. 5. A radial flange 63 projects outwardly from the rim and is received at the bottom of'the recess 29 where it is compressed between the central body portion, or hub, 12 of the adapter and the rotatable end pieces to form a gas-tight seal. The rim of the valve units also extends longitudinally with respect to the central collar and is tapered to provide an annular valve seat 64 against which a valve disc 66 is adapted to be seated. The valve disc is preferably made of a thin, flexible material such as rubber and has an opening at its center which is stretched over the retaining stem 30 so that the outer edge of the disc is free tomove toward or away from the valve seat 64 in" response to the patients breathing. The disc valve element 66 can be moved along the length of the retaining stem 30 to the desired position relative to the annular valve seats 64. It may be seen that the abutment of the collar 58 of the exhalation check valve against the cylindrical receptacle 32 for the retaining stem serves to orient the inner end of the disc valve of the exhalation valve unit Similarly, the abutment of the collars 58 between the inhalation andexhalation valves serves to orient the disc valve element of the inhalation check valve. The collars 58 terminate a slight longitudinal distince within the plane of the annular valve seat 64 so thatwhen the' central portions of the valve discs are oriented as shown in the drawing, the discs will bedeflected slightlywith respect to'the centers thereof causingthem to be undera slight seating stress against the respective valve seats. It will beunderstoodthat it is desirable, in breathing check valves of this type, to produce a slight seating stress which will prevent back flow through the respective check valves .but which, at the same time, will not produce any noticeable interference'with the patients respiration.

A further feature of the check. valve units 54'and 56 involves the arrangement of the collar portions 58; with respect to the radial flange portions 63 such that" the valve units cannot inadvertently be mounted incorrectly within the adapter. This is obtained by locating the annular rim 60 toward one end of the collar 58 such that it 'is not symmetrical with respect t'o'the length thereof. When the check valve units are placed on the retaining stem 30 as shown in the drawings; during assembly of the adapter, 'it will be seen that the end piece16 is free to'be placed within the corresponding recess 29 and that similarly the end piece '14 is free to be receivedin the opposing recess. The assembly may then be secured in the desired manner by tightening the retaining nut 36 as previously described. On the other'haud, if it be assumed that one or the other. of the check valve units or both of them have been placed on the stem 30 in the reverse direction, it will be seen thatthe different spacing between the flanges 63 and the projecting ends'of the collars 58 will produce an interference between one or both of the end pieces and the central hub preventing their being seated in the usual manner. This 'will, of course, call immediate attention to the incorrect arrangement of the valve units so that it may be rectified without the risk of harmful effect to the patient. It may be seen, if no such safeguard were provided against inadvertent reversal of either of the check valves, that the patient might be prevented from inhaling or exhaling upon application of the breating apparatus to the patient.

As mentioned above, the central body portion 12 of the adapter is of a transparent plastic material that is electrically nonconductive and which consequently forms an insulation with respect to the conduction of electrical charges between the rotatableend pieces 14 and 16 carrying the conductive conduits 18 and 20 and the face mask 24 which, as previously mentioned, is either normally made of a suitable conductive rubber material or is otherwise rendered sufiiciently conductive to allow dissipation of static charges that may be imparted thereto. This difiiculty is overcome in the present device by the provision of a metallic bushing shown at 70 in FIG. 1 forming a sheath, or sleeve, carried on'the tubular connector nipple 22 of the adapter which is seated in the face mask. It will be seen that the metallic bushing includes a longitudinal portion seated within the mask opening 25 that is in intimate contact with the surrounding wall of the mask. At the upper end the bushing hasa radial flange 72 which is more easily seen in FIGS. 3 and 4 from which a pair of prongs 74 and 76 extend up-' wardly, longitudinally of the bushing. The outer diameter of the flange 72 corresponds substantially to the width of the central body portion, or hub, .12 of the adapter so that the edge of the flange 72 coincides substantially with the flat end face of the hub: In each of the end faces, a vertical recess 78 is formed which is slightly 'wider'than the width of the prongs 74 and 7 6. The recesses 78 are adapted to receive the prongs when the bushing 70 is placed over the tubular connector portion 22. As shown in FIG. 3, the tubular prongs 74 and 76 have been depressed and are positioned substantially within their respective accommodating recesses 78. The

. 6 recesses are not readily visible in this sectional view. The prongs 74 and 76 initially are bent outwardly slightly from the'a'ccess of the'bushing asindicated in FIG. 4 and as shown by the dotted lines in FIG. 3. The dotted lines show the positionsfofthe prongs before the end pieces 14 and 16 of the adapter are assembled. When, however,l the' end: pieces are'inse'rted in the receiving recesses}? at the opposite faces of the central hub of the adapter andsecu'red thereagainst, as hereinabove described, the'shoulders 80 and 82 respectively, which are formed 'odthe 'confrontingffaces of the end pieces 14 and "1 6j,. bear inwardly againstthe diverging prongs 74 and'76 and press" them inwardly to the positions shown in 3. .In these positions, of course, the prongs are deflected from their normal divergent configuration creating "a: stress m'thinthe prongs which resiliently urges theprongs outwardly to maintain contact'thereof with the confronting shoulders of the respective end pieces. Thus, when the collar70 is assembled 'on the central body portion of the adapter as shown, and the end pieces are mounted therein in the usual'manner, the prongs 74 and 76" maintain a. resilient contact between the end pieces and the bushing affording a continuous electrical conductive path between the end pieces and the face mask. The

prongs, of course, continually bear against the shoulders 8'0'and 82 ofthe end-pieces throughout all angular positions of the end pieces} Such an electrically conductive path, of course, is also provided if the adapter in connected instead with a catheter or other inhaler device, in which case the adapter nipple, provided with an interposed' conductive element such as the sheath 70 will similarly-maintain a conductive path between the sheath and the adjustable vend pieces. It is preferable to construct the bushing 70 such that it is a press fit on the tubular connecting portion 22 of the adapter so that it will be self-retaining thereon and nonsusceptible to inadvertent separation therefrom.

It is apparent from the preceding description that a highly advantageous adapter device for anesthetic circuits is provided in accordance with the present invention which affords a high degree of flexibility of adjustment; furnishes visibility of the interior portions of the cone nector while at the same time not interfering with the desired continuity of an electrically conductive path be tween the inhaler device and the remaining portions of the anesthetic circuit that are properly and adequately grounded; and which enables the disposition of the check valves in a simple and convenient manner in the adapter subject to visual inspection. The invention, of course, is not limited to the specific embodiment herein described but may be used in other ways without departure from its spirit as defined by the following claims.

I claim:

1. An adjustable connector for anesthetic administering circuits comprising a housing having a breathing chamber therein and an opening adapted to be placed in communication with an inhaler, said housing including at least. a portion thereof which is transparent to enable visual inspection of said breathing chamber, relatively adjustable connector means having passages communicating with said breathing chamber adapted to receive gas conduits thereon for circulating gas to and from said chamber, and means resiliently engaging at least one of said-relatively adjustable connector means adapted to contact an inhaler placed in communication with said opening of said breathing chamber, efiective to maintain an electrically conductive path therebetween.

2. In a Y-adapter forinhalent anesthetic administering apparatus, a body defining a breathing chamber having a transparent wall portion, connector means forming a gas passage communicating with said breathing'chamber adapted to form a gas connection with an inhaler, inlet and outlet fittings adjustably mounted on said body having corresponding passages communicating respectively '7 with said breathing chamber, electrically conductive contact means forming a part of said connector means, and resilient means forming an electrically conductive connection between said electrically conductive contact means and at least one of said fittings.

3 ha Y-adapter for inhalant anesthetic administering apparatus having a connector adapted to be connected with an inhaler and relatively adjustable conduit fittings adapted to receive gas conduit means, electrically conductive contact means forming a part of'said connector adapted to form an electrical contact with inhaler means and resilient means forming an electricallyconductive path between said contact means and said adjustable conduit fittings.

4. An adapter fitting for anesthetic administering apparatus adapted to provide a gas connection between inhalation and exhalation conduits of an anesthetic breathing circuit and an inhaler comprising a body portion defining a breathing chamber and having a connector including a passage communicating with said chamber adapted to be connected with an inhaler, adjustable conduit fittings separably mounted on said body portion adapted to receive thereon, respectively, inhalation and exhalation conduits of a breathing circuit :haw'ng corresponding passages therein communicating with said breathing chamber, electrically conductive contact means carried on said connector of said body portion arranged to form an electrical contact with an-inhaler received thereon and resilient means compressed by at least one of said separable conduit fittings forming a part of said electrical contact means biased so as to maintain engagement with said conduit fitting throughout the range of adjustment thereof.

5. A Y-adapter for inhalant administering apparatus comprising a central hub having a breathing chamber therein opening in opposite end faces of said hub, means forming a connector adapted to be connected with an inhaler having a gas passage communicating with said breathing chamber, corresponding end pieces adjustably secured against the opposite end faces of said hub hav ing gas passages therein respectively communicating with said breathing chamber which are adapted to receive inhalation and exhalation conduits respectively of an anesthetic breathing circuit, detachable retaining means including an elongated stem extending between said end pieces through said hub having an adjustable portion externally accessible to permit said end pieces to be adjustably secured against the opposite end faces of said hub and inhalation and exhalation check valve-.means,-re-.

spectively, carried by said elongated stem of said retaining means at spaced intervals along the length thereof, and arranged within said adapter to separate said breathing chamber from said passages of said adjustable end pieces.

6. A Y-adaptcr for inhalant administering apparatus comprising a central hub having a breathing chamber therein opening in opposite end faces of said hub, means forming a connector adapted to be connected with an inhaler having a gas passage communicating with said breathing chamber, corresponding end pieces adjustably secured against, the opposite end faces of said hub havinggas passages therein respectively communicating with said breathing chamber which are adapted to receive inhalation and exhalation conduits respectively of an anesthetic breathing circuit, detachable retaining means extending bet ween said end pieces through said hub having an adjustable portion externally accessible to permit said end pieces to be secured against the opposite end faces of said hub and inhalation and exhalation check valve means respectively carried by said retaining means and arranged within said adapter to separate said breathing chamber from said passages'of said adjustable end pieces, said retaining 'means' including an elongated'stem secured in one of said end pieces and protruding through said other end piece, said externally accessible securing means including a nut threadedly received on said protruding end of said stem and said check valve means each'including a sleeve member slidably received on said stem between said end pieces and having radially spaced annular rim port-ions compressed between said respective end faces ofsaid hub and said corresponding end 7. A.Y-adapter according to claim 6 'wherein said annular rim portions of said checkv-alve means are dis posed nonsymmetrically with respect to the lengths of said sleeve members such that said end pieces may be secured in said hub in only asingle predetermined orientation of said check valve means.

8. A Y-adapter in accordance with claim 7 wherein said hub includes a transparent wall portion.

9. A Y-adapter for inhalant anesthetic administering apparatus comprising a central hub constructed of a substantially transparent electrically nonconductive'material, said hub defining a breathing chamber therein opening at opposite substantially parallel end faces of said hub, a cylindrical protrusion extending outwardly from said hub adapted to be connected with an inhaler including electrically conductive contact means thereon adapted to be placed in electrical contact with an inhaler connected therewith, corresponding end pieces rotatably received respectively against the opposite end faces of said hub having gas passages therein communicating respectively with said breathing chamber, retaining means extending between said opposite end pieces through said hub adjustable to tighten said end pieces against the opposite end faces of said hub, inhalation and exhalation check valve means carried on said retaining means disposed respectively to separate said breathing chamber from the gas passages in said end pieces and resilient means forming apart of said electrical contact means extending upwardly contiguously with said end faces of said hub deflected by said end pieces so as to produce a stress under which said resilient means is biased toward said end pieces to frictional engagement therewith throughout the rotated adjustments of said end pieces.

10. A Y-adapter for inhalant administering apparatus comprising a central hub having a breathing chamber therein opening in opposite end faces of said hub, means forming a connector adapted to be connected with an inhaler having a gas passage communicating with said breathing chamber, corresponding end pieces adjustably secured against the opposite end faces of said hub having gas passages therein respectively communicating with said breathing chamber which are adapted to receive inhalation and exhalation conduits respectively of an anesthetic breathing circuit, detachable retaining means vextending between said end pieces through said hub having an adjustable portion externally accessible to permit said end pieces to be secured against the opposite end faces of said hub, valve seat means defining a valve opening separating said gas passages in said end pieces from said breathing chamber, said detachable retaining means extending through said valve openings in fixed spacial relation thereto, and separate valve elements carried on said retaining means disposed in operative relationship to each of said valve seat means to coact therewith to alternatelyopen in response to breathing and thereby place said breathing chamber in communication with one or the other of said end pieces during inhalation and exhalation.

References Cited in the file of this patent UNITED STATES PATENTS

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